The Granite Advantage Health Care Program, more commonly known as Medicaid Expansion, is a unique New Hampshire solution that ensures all Granite Staters have access to health insurance. Medicaid Expansion is available to adults aged 19 to 64 who earn $20,815 or less per year (or $42,760 or less for a family of four). Over the past year, an average of 58,846 individuals were enrolled in Medicaid Expansion each month, using their insurance coverage to access necessary health care services including mental health care, substance use disorder treatment, and preventive and emergency room care. This program is New Hampshire's best tool in the fight against the ongoing substance use and mental health crises.
As a state, we must protect this vital program that helps all our residents get the health care they need and deserve. SB 134 would create unnecessary barriers to care by setting burdensome work requirements for Medicaid Expansion, putting thousands of low-income Granite Staters at risk of losing their health insurance.
About the Bill
SB 134 would set work requirements for Medicaid expansion recipients, requiring low-wage individuals to prove they complete 100 hours of qualifying activities each month to be eligible for health coverage. Research consistently shows that work requirements can cause significant numbers of people to lose their coverage, complicate access to care, and disproportionately harm those who need Medicaid the most.
Learn More: The Consequences of Work Requirements
National data shows that the majority of adult Medicaid enrollees are already working. In 2023, 64% of adults covered by Medicaid were working full- or part-time. Of those not working, the top reasons reported were caregiving responsibilities, illness or disability, or school attendance. Only 8% of Medicaid adults reported they were retired, unable to find work, or not working due to other reasons.2
Work requirements pose a number of problems. They cause:
- Barriers to employment: Medicaid Expansion supports employment and our state's workforce by helping people get back to work. Access to necessary health care keeps people healthy and working, while losing health coverage makes it more difficult to manage health conditions necessary for maintaining employment.
- Gaps in coverage: When New Hampshire attempted to enforce work requirements in 2019, approximately 17,000 residents risked losing coverage1. When Arkansas initiated work requirements in 2018, about one in four enrollees, which was more than 18,000 individuals, lost their coverage within the first 7 months.3 Losing health coverage can cause gaps in care, leaving people without any options for health coverage.
- Administrative burdens: Work requirements add an administrative burden that is costly and difficult to implement. Many eligible individuals face barriers to compliance, such as difficulty proving work status and reporting qualifying activities.1
Learn More: Medicaid Expansion's Impact in New Hampshire
Since its inception in 2014, Medicaid Expansion has helped hundreds of thousands of Granite Staters access health care services. Across the 2024 fiscal year, 92,583 New Hampshire residents were enrolled in Medicaid Expansion at some point during the year.4
MedEx Helps Residents Access Mental Health and Substance Use Services
This program is especially important for Granite State individuals in need of mental health care and substance use disorder treatment, with about one in three recipients accessing these services. More than 25,000 people received mental health treatment and nearly 7,500 people accessed substance use disorder services in the last fiscal year.4 Medicaid Expansion makes a real difference, helping our residents receive the care they need to get healthy and contribute to their communities.
MedEx Increases Access to Care in Rural Regions of NH
Medicaid Expansion enrollment rates are higher in rural regions of New Hampshire, both increasing access to health care coverage in these communities and returning federal dollars to local economies.4, 5 This particularly benefits small, rural hospitals, helping them provide critical health services that could otherwise be difficult to access in these communities.5
MedEx Lowers Rate of Uninsured Residents
In the five years following Medicaid Expansion's inception in New Hampshire, the number of residents without health coverage declined. This drop was approximately 58,000 individuals, which is a 42.3% decline in the number of Granite Staters without health coverage.5
Take Action
Email Lawmakers - Oppose Work Requirements in the Budget
Call Lawmakers - Script Provided!
A phone call is the most effective way to contact a legislator when advocating on a specific issue or bill. It is helpful for many people to prepare beforehand—please find a sample script and contact information below.
Please note Senators have a staff person who answers their phone. Representatives use their personal numbers, so sometimes a family member will answer the phone. Politely ask to leave your name and number with them. If they do not answer, leave a brief message with your name, the town in which you live, and your phone number.
Committee of Conference Members and Contact Information:
Rep. Kenneth Weyler: 603-642-3518
Rep. Dan McGuire: 603-782-4918
Rep. Joe Sweeney: 603-327-7184
Rep. Jose Cambrils: 603-731-8287
Rep. Mary Jane Wallner: 603-225-5249
Sen. Sharon Carson: 603-271-3266
Sen. James Gray: 603-271-4980
Sen. Cindy Rosenwald: 603-271-3207
Call Script:
"Hello [Senator or Representative] [Last Name]. My name is [your name here] and I live in the town of [your town].
I am calling to ask you to oppose work requirements for the Granite Advantage Health Care Program, also known as Medicaid expansion, in the state budget.
- Over the past year, an average of 58,846 individuals were enrolled in Medicaid Expansion each month, using their insurance coverage to access necessary health care services including mental health care, substance use disorder treatment, and preventive and emergency room care. This program is New Hampshire's best tool in the fight against the ongoing substance use and mental health crises.
- Data shows that the majority of adult Medicaid enrollees are already working—92% of adults covered by Medicaid either work or are not working due to caregiving responsibilities, illness or disability, or school attendance.
- Research consistently highlights the negative consequences of work requirements. New Hampshire's 2019 attempt put 17,000 of our residents at risk of losing coverage. Gaps in coverage make it harder for individuals to manage chronic conditions and remain employed.
- Work requirements add an administrative burden that is costly and difficult to implement, with many eligible individuals facing barriers to compliance, putting an additional strain on state resources.
- [Include your personal or professional experience with Medicaid expansion, and any other personal remarks you'd like!]
Thank you for your time and consideration on this issue."
Share Your Story
Please share your experience with Medicaid programs, including Medicaid Expansion, using the form below. Consider the following questions in your story.
- How has Medicaid impacted your access to health care and your life overall?
- What does it mean for you/your family to have health insurance, and how would your life be different without this coverage?
- What health services have you received through Medicaid programs – from doctor visits to mental health care to prescriptions – and how have they made a difference in your life?
Spread the Word: Fact Sheet
Bill Status
The House Health, Human Services and Elderly Affairs Committee voted 18-0 to retain Senate Bill 134. This means the committee will hold onto the bill for now and review it further later this year. The Senate included Medicaid expansion work requirements in its budget proposal, which was passed on June 5. Since the budget bills were amended by the Senate, a Committee of Conference has formed to negotiate the differences between the House and Senate versions. Email members of the committee to urge them to oppose work requirements in the state budget!
Bill Progress:
February 5: Senate Health and Human Services Committee Hearing
February 13: Senate Health and Human Services Committee recommends that the bill passes (Ought to Pass) by a
vote of 3-2
March 6: Senate passes the bill in a 16-8 vote
March 11: Senate Finance Committee recommends that the bill passes (Ought to Pass) by a vote of 4-2
March 20: Senate passes the bill in a 15-8 vote
April 16: House Health, Human Services and Elderly Affairs Committee Hearing
April 30: House Health, Human Services and Elderly Affairs Committee retains the bill in a 18-0 vote.
More Threats to Medicaid
In addition to Senate Bill 134, New Hampshire's Medicaid programs are facing other state-level and significant federal-level threats. New Futures is working alongside NH Medicaid Matters, a group of organizations across the state, to protect our Medicaid programs. In New Hampshire, Medicaid helps over 187,000 of our residents, including children, pregnant women, people with disabilities, veterans, and older adults in nursing homes, access the care they need.
Learn more about the potential policy changes that would impact Medicaid and how you can take action to show lawmakers that New Hampshire needs Medicaid by clicking the button below.
